NC Medicaid Managed Care Incremental Innovations Waiver DCW Rate Increases effective October 1, 2026, retroactive to July 1, 2026.
Topics Related to Medicaid Managed Care
The Centers for Medicare & Medicaid Services released the 2027 ICD-10 code list, Effective Oct. 1, 2026.
Updating the date format requirement for Hospital UR Plan submission.
Beginning Nov. 1, 2026, Pharmacy Claims for controlled substances will be denied without an active certification on their NCTracks provider enrollment record.
Reminders for NC Medicaid Managed Care, NC Medicaid Direct and Medicare.
Effective July 24, 2026, Basaglar® U-100 KwikPen® moved to Preferred status due to reported shortage of Lantus SoloStar pen.
The revised NC Medicaid 1915(i) assessment must be used starting Oct. 1, 2026, and includes a new companion guide.
This bulletin replaces in full the December 2025 Utilization Management by Managed Care Plans Aligned with Food and Drug Administration Labeling bulletin.
NC Medicaid, in collaboration with the four NC Medicaid Managed Care Standard Plans, will host the Sixth Annual Virtual Statewide Quality Forum on Wednesday, Oct. 14, 2026, from 11 a.m. to 1 p.m.
Amendments to Clinical Coverage Policy 1A-20, expanding medical necessity criteria and updating coverage for sleep studies and polysomnography services are effective July 1, 2026.